NEAR INFRARED SPECTROSCOPY FOR HEMODYNAMIC MONITORING IN NEONATES UNDERGOING

用于新生儿血流动力学监测的近红外光谱

• 批准号: 8356758
• 负责人: OLUYINKA OLUROTIMI OLUTOYE
• 金额: $ 0.01万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-12-01 至 2011-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8356758
• 关键词: Acidosis; Age-Years; Arteries; Bilateral; Birth; Blood; Blood capillaries; Blood gas; Brain; Brain region; Cannulas; Cerebral hemisphere; Cerebrum; Clinical Research; Control Groups; Data; Defect; Diaphragmatic Hernia; Extracorporeal Membrane Oxygenation; Funding; Grant; Incidence; Kidney; Kidney Failure; Life; Ligation; Magnetic Resonance Imaging; Mechanical ventilation; Monitor; National Center for Research Resources; Near-Infrared Spectroscopy; Neurologic; Newborn Infant; Observational Study; Operative Surgical Procedures; Outcome; Oxygen; Patients; Perfusion; Principal Investigator; Research; Research Infrastructure; Resources; Risk; Source; Techniques; Technology; Time; Tissues; United States National Institutes of Health; Venous; Weaning; Weight; capillary; congenital heart disorder; cost; hemodynamics; indexing; neonatal pulmonary hypertension; neonate; repaired; venule

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. Primary support for the subproject and the subproject's principal investigator may have been provided by other sources, including other NIH sources. The Total Cost listed for the subproject likely represents the estimated amount of Center infrastructure utilized by the subproject, not direct funding provided by the NCRR grant to the subproject or subproject staff. Extracorporeal membrane oxygenation (ECMO) is an accepted therapy for newborns with life-threatening conditions such as diaphragmatic hernia, pulmonary hypertension of the newborn and severe congenital heart disease. These patients are at risk of compromised cerebral perfusion and/or of developing renal failure during ECMO. The efficacy of tissue perfusion in these patients is estimated by a variety of indirect means tissue lactate content, acidosis, blood gas parameters, etc. The primary purpose of this observational study is to assess bilateral cerebral oxygenation when one cerebral hemisphere is potentially compromised, i.e. unilateral carotid ligation or large venous cannula. Furthermore, we hope to relate oxygen saturation to short and long term neurodevelopmental outcomes and to relate renal oxygen saturation to incidence of ECMO related renal failure. Near-infrared spectroscopy (NIRS) is a non-invasive technique that can be used to compute the oxygen saturation for blood in certain tissues. The regional cerebral oxygen saturation index (rSO2i) represents the weighted average of the oxygen saturation of the arteries, venules, and capillaries in certain regions of the brain. We will use this technology to monitor the cerebral blood oxygen saturation of our patients from birth until they go on ECMO, while they are on ECMO, during any surgical repair of defects (whether on ECMO at the time or not), and while the patients are being weaned from ECMO. NIRS data will also be collected from a control group of ECMO candidate neonates that are not placed on ECMO. After the patients have recovered, are off of mechanical ventilation, and are progressing well, a brain MRI is typically performed prior to discharge. The findings of these MRIs as well as the findings of neurological and neurodevelopmental examinations made at six months and one year of age will be analyzed.

该子项目是利用资源的众多研究子项目之一 由 NIH/NCRR 资助的中心拨款提供。子项目的主要支持 并且子项目的主要研究者可能是由其他来源提供的， 包括其他 NIH 来源。 子项目可能列出的总成本 代表子项目使用的中心基础设施的估计数量， NCRR 赠款不直接向子项目或子项目工作人员提供资金。 体外膜肺氧合（ECMO）是治疗患有膈疝、新生儿肺动脉高压和严重先天性心脏病等危及生命疾病的新生儿的公认疗法。 这些患者在 ECMO 期间面临脑灌注受损和/或发生肾衰竭的风险。 这些患者的组织灌注效果是通过组织乳酸含量、酸中毒、血气参数等多种间接手段来估计的。 这项观察性研究的主要目的是评估当一侧大脑半球可能受到损害时（即单侧颈动脉结扎或大静脉插管）时的双侧大脑氧合情况。 此外，我们希望将氧饱和度与短期和长期神经发育结果联系起来，并将肾氧饱和度与 ECMO 相关肾衰竭的发生率联系起来。 近红外光谱 (NIRS) 是一种非侵入性技术，可用于计算某些组织中血液的氧饱和度。 区域脑氧饱和度指数（rSO2i）代表大脑某些区域的动脉、小静脉和毛细血管的氧饱和度的加权平均值。 我们将使用这项技术来监测患者从出生到接受 ECMO 期间、接受 ECMO 期间、任何缺陷修复手术期间（无论当时是否接受 ECMO）以及患者脱离 ECMO 期间的脑血氧饱和度。 NIRS 数据还将从未接受 ECMO 的 ECMO 候选新生儿对照组中收集。 患者康复、停止机械通气且病情进展良好后，通常会在出院前进行脑部 MRI 检查。 将分析这些 MRI 的结果以及六个月和一岁时进行的神经学和神经发育检查的结果。